Title: HPV Knowledge Awareness and Vaccine Acceptability among Inner-City Black Males Principal Investigator: Sherrie Flynt Wallington, PhD Abstract Human papillomavirus (HPV), the most common sexually transmitted virus in the United States, remains a considerable public health problem. The District of Columbia has one of the highest incidences of occurrence, and consequently has a cervical cancer rate of 10.4 per 100,000 females, among the highest in the nation. HPV has been associated with anogenital warts and cancers of the cervix, penis, and anus, and also with vulvar, vaginal, and oropharyngeal cancers. In 2006, the Food and Drug Administration approved the marketing of Gardisil, a prophylactic quadrivalent HPV vaccine for females between the ages of 9 and 26. In 2009, this approval was extended to males of this same age group. Moreover, although public awareness and understanding of the sexually transmitted human papillomaviruses and the available HPV vaccines are low among both females and males, HPV knowledge and awareness is particularly low among minority and underserved males. In 2009, the District of Columbia (DC) made HPV vaccination mandatory for all girls entering the 6th grade, with an opt-out option available by parental request. While the DC government promised to focus an extensive educational effort around this vaccine, this did not materialize, and the mechanism to opt-out of the vaccine was never developed to be user-friendly. Consequently, parents have specifically requested HPV research and a separate adolescent educational intervention for males and females. Thus, limited research has examined HPV knowledge, awareness, and perceptions among males toward the HPV vaccination, particularly among minority and underserved males. This proposed new study, however, will focus on adolescent males and seeks to: 1) To explore Black adolescent males' knowledge, attitudes, and barriers regarding HPV and the HPV vaccination (Phase I: Focus Groups & Phase 2: Key Informant Interviews), and 2) Using the results from the focus groups and key informant interviews, design and implement a survey that assesses health communication factors in this population of Black adolescent males (e.g. health information seeking, HPV health literacy), and analyze the responses for association with their intention to undergo HPV vaccination (Phase 3: Survey). The proposed study design provides experiential (focus groups), attitude/behavioral, (survey research-cross sectional and convenience sampling), and expert data (key informant interviews). Although this pilot focuses on Black males, establishing infrastructure and feasibilit with the study findings will be useful in facilitating the development of strategies for other adolescents of all racial and ethnic groups, as well as for family intervention studies targeting the family unit as a whole. Moreover, this research will also build further research capacity to engage underserved adolescents in future HPV and cancer prevention interventions. PUBLIC HEALTH RELEVANCE: Male HPV vaccination is expected to reduce the incidence of HPV and HPV-related disease (such as cancer and genital warts) in males and females, and also to provide more security against HPV since coverage among girls is likely to be incomplete. Gender-neutral vaccination would be expected to reduce overall viral transmission in the entire population. Data from this pilot project will be used to develop a future HPV randomized controlled educational intervention targeting Black adolescent males, a population not often engaged in the research enterprise. Moreover, this research builds a basis for translating and disseminating information about the HPV vaccine, a new scientific discovery.